Considering the five stakeholders in health care: consumers, providers, payers, suppliers, and regulators – what role can each play in health care quality, and cost containment?

Considering the five stakeholders in health care: consumers, providers, payers, suppliers, and regulators – what role can each play in health care quality, and cost containment?

Module 1: Assignment

Assignment:

Professional Development

• Considering the five stakeholders in health care: consumers, providers, payers, suppliers, and regulators – what role can each play in health care quality, and cost containment?
• In your opinion, what health policy has had the greatest impact on health care in the United States? Why?
• Frame some arguments for or against the policy of mandated minimum staffing ratios in the positive versus normative economic dichotomy.

This APA essay will have 1200-1500 words with 4 supporting references. Make certain to include an introduction and conclusion paragraph, along a title and reference page.

Expert Answer and Explanation

Professional Development

Engaging with stakeholders is an essential element in which the organization can attain its success. The organization has to ensure a clear vision obtained from a wide and strategic process of planning and the marketing plan. A healthcare setting that facilitates effective engagement can easily translate their needs to meet the industry requirements or otherwise facilitate strategic development. Stakeholder understanding also ads in the identification of a common ground that unifies all the stakeholders with regards to their requirements and needs (Yoo, 2018).

Each stakeholder is unique, and their needs might either be dependent on each other or entirely independent. Both external and internal stakeholders have to work together to ensure that they meet the required stipulations and increase the organization’s performance. Internal stakeholders interact with the healthcare facility daily and can ensure that the organization meets all the required thresholds. This consolidation of stakeholder requirements, as well as that of the healthcare organization, is able to affect the overall health and cost of containment.

Consumers

Consumers within the healthcare system comprise of the patients and other individuals that need medical services. Patients are required to be treated with the high measure of quality to ensure satisfaction and guarantee on the various ways in which care will be provided to them while at the facility. For the healthcare facility to attend and meet each patient’s demand, they have first to identify the current trends that are prevailing in facilitating patient outcome and satisfaction (Okeke et al., 2019).

Different patients present different medical conditions that required advanced medical expertise and medical equipment to mitigate. Some may also seek medical care with comorbid illnesses that are complex to diagnose and treat. These conditions have an impact on the overall quality of care, as well as the cost of containment. For instance, it becomes costly to treat and offer continuous quality care to a patient with multiple illnesses without proper finances.

Providers

Health care providers constitute the internal stakeholders as they comprise the administration, nurses, and doctors required to attend to patient needs. A healthcare facility has to ensure that they provide high-quality care that meets the demands of the patient. The facility also needs to abide by industry standards. The quality of care is dependent on the ability of the providers to guarantee their effectiveness (Bastian, Munoz, & Ventura, 2016). This construct defines the role in which the providers can ensure high-quality care and cost containment.

One way to facilitate quality care is by hiring quality personnel to oversee the facility’s operations. Quality nurses and doctors reflect the potential to deliver quality care. Health care providers can also ensure that there is sufficient and high-quality technology in line with industry-specific needs. Through the use of the electronic records system, the facility can ensure that the services provided are of high quality (Okeke et al., 2019).

These two services may have an initial implication on the cost. The provision of high-quality care will help with cost containment by offering an effective positive healthcare image and an increased number of patients. Providers also facilitate the issue of quality in healthcare by adopting the standard and acceptable models of practice, such as the use of EBP, which inform the best treatment options and create policies.

Payers

Health care payers include insurance companies, employers, the government, and the out-of-pocket payment model. These alternatives have a role to play when it comes to ascertaining the quality of care and the overall cost containment. To begin with, the insurance company act as an intermediary between the patient and the healthcare facility. With the insurance in place, the patient is guaranteed access to quality care without considering the financial implication.

For instance, Medicare and Medicaid offer financial aid to elderly patients within the United States, helping them acquire medical care that is of high quality and specific to their specific needs. Insurance agencies also create measures that limit the charges that the healthcare organization charge on specific service provisions (Bastian, Munoz, & Ventura, 2016). The agencies also limit the amount that the organization can charge a patient in a single hospital visit creating a measure against cost containment.

Secondly, the government also has direct impacts on the quality of care as well as cost containment. The government is the major financier for public hospitals and other government-owned insurance covers. In this manner, the government, either state or federal, can ensure that the public healthcare facilities are well equipped and create policies that dictate the quality of care that can be provided to patients (Bastian, Munoz, & Ventura, 2016). Similarly, it also offers the same services as the private insurance companies but allows the beneficiaries to afford the provide healthcare services. On the other hand, out-of-pocket payment is also a viable payment option, but people with low income may hinder the affordability of quality services.

Suppliers

The quality of healthcare performance can be based on the supplier able to provide quality equipment and medication. Suppliers also play a critical role in ensuring the provision of quality care within an organization. First, suppliers of medicines can ensure that the medication is delivered on time and meet s the standards required by the market’s standards. Additionally, supplier integrity is essential in ensuring the medical supplies provided are up to standard and perform what they are meant to (Falasca, & Kros, 2018).

Technological suppliers also have to ensure adherence to the standards of healthcare IT supplies. One of the healthcare facilities ‘ objectives is to ensure the provision of quality care, and the use of medical technology equipment and medicines from the supplier is an essential way to achieve these goals.

Suppliers also help with the aspect of cost containment in one way. Timely delivery of materials and medication facilitates the efficiency of services and long-term benefits (Falasca, & Kros, 2018). Suppliers can also participate in cost containment when they enter into a long term understanding with the healthcare facility to acquire medical supplies and equipment at a reduced price. In this way, the healthcare facility is able to cut on costs used to purchase medical supplies.

Regulators

Health care regulators provide guidelines and policies that healthcare provides need to use in order to facilitate efficient care. Regulators mainly emphasize how the healthcare consumer will be able to get quality healthcare by ensuring that the facility operates at optimal capacity. Another way that the regulator helps with the provision of quality care includes the use of licensing and certifications required by the organization to achieve certain elements of care. Licensing of healthcare organization requires strict adherence by the facility on standard procedures required for a healthcare facility (Hosseinichimeh et al., 2019).

These features maximize patient security and the nature of quality care. Regulators also provide rules on how to ensure patient safety and security of their data. Patient safety also facilitates an environment of trust between the patient and the facility. This correlation will ensure that the patients are accorded quality treatment and care, ensuring satisfaction.

Health Care Policy

In my opinion, the Affordable Care Act of 2010had the greatest impact on health care in the United States. Since the implementation of the Act, the American healthcare system has drastically changed with the inclusion of numerous incentives for both the patient and the healthcare industry. To begin with, the policy leads to increased accessibility to healthcare by many people (Griffith, Evans, & Bor, 2017). Though the provision of insurance covers that are affordable by the low-income earners, the policy facilitated an increase in the people with healthcare coverage.

Additionally, the health care system was able to encounter an increase in the number of consumers prompting them to increase their overall size and practitioners to attend to the high numbers of patients able to afford the care. The Affordable Care Act provides financial aid to the elderly in the community, children, and the disabled. The incentives are subsidized, and the health care quality they offer is of high quality, leading to patients’ leading quality life.

Mandated Minimum Staffing Ratios

The mandated staffing ratios aid with ensuring a balance between service providers and patient population. The policy ensures that while the nurses are ensuring high quality care, there is also guaranteed safety of their health and emotional standpoint (Griffith, Evans, & Bor, 2017). The policy also creates a working environment that facilitates a standard nurse-patient ratio leading to a shortage of nurses and the need for the organization to facilitate employment of additional nurses. Be that as it may, the current COVID-19 has hard a hit on the normative economy making it difficult to balance the ratios. However, the facilities can still ensure maintained healthcare services and retention of the available nurses.

Conclusion

In conclusion, the consolidation of stakeholder requirements and that of the healthcare organization can affect the overall health and cost of containment. Different stakeholders have different needs and impacts on a healthcare facility. To meet these demands, they have to work together to benefit from quality healthcare and cost containment. Alternatively, the Affordable Care Act has been essential in facilitating improved patient care for the patients and creating a safe environment for providing healthcare services.

References

Bastian, N. D., Munoz, D., & Ventura, M. (2016). A mixed-methods research framework for healthcare process improvement. Journal of Pediatric Nursing, 31(1), e39-e51.

Falasca, M., & Kros, J. F. (2018). Success factors and performance outcomes of healthcare industrial vending systems: An empirical analysis. Technological Forecasting and Social Change, 126, 41-52.

Griffith, K., Evans, L., & Bor, J. (2017). The Affordable Care Act reduced socioeconomic disparities in health care access. Health Affairs, 36(8), 1503-1510.

Hosseinichimeh, N., Kim, H., Ebrahimvandi, A., Iams, J., & Andersen, D. (2019). Using a stakeholder analysis to improve systems modelling of health issues: the impact of progesterone therapy on infant mortality in Ohio. Systems Research and Behavioral Science, 36(4), 476-493.

Okeke, F., Tseng, E., Piantella, B., Brown, M., Kaur, H., Sterling, M. R., & Dell, N. (2019, July). Technology, home health care, and heart failure: A qualitative analysis with multiple stakeholders. In Proceedings of the 2nd ACM SIGCAS Conference on Computing and Sustainable Societies (pp. 122-133).

Yoo, D. (2018). Stakeholder Tokens: a constructive method for value sensitive design stakeholder analysis. Ethics and Information Technology, 1-5.

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FAQs:

What are the roles and responsibilities of stakeholders in healthcare?

Roles and Responsibilities of Stakeholders in Healthcare

Healthcare stakeholders include patients, providers, payers, policymakers, and organizations, each playing a vital role:

• Patients: Actively participate in their care and decision-making.

• Healthcare Providers: Deliver quality care and follow ethical guidelines.

• Insurers/Payers: Fund healthcare services and manage costs.

• Policymakers: Develop regulations and policies to improve healthcare systems.

• Healthcare Organizations: Ensure efficient healthcare delivery and innovation.